<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html>

 <head>
   <title>Fedora Free Media Form</title>
   <style type="text/css" media="screen">
     @import url("https://fedorapeople.org/userdefs/css/fedora.css");
     @import url("https://fedorapeople.org/userdefs/css/style.css");
   </style>
 </head>

 <body>

   <div id="wrapper">

     <div id="head">
       <h1><a href="http://fedoraproject.org/">Fedora</a></h1>
     </div>
     <div id="sidebar">
       <div class="nav">
         <h2>Navigation</h2>
         <ul>

           <li><strong><a href="/">Home</a></strong></li>

         </ul>
       </div>
     </div>
<div id="content">
<center>
<h3>Fedora Free Media Request Form</h3>


<p>
To request <b>ONE</b> copy of Fedora DVD or Live Media by mail, please fill out <b>ALL</b> the following informations:<br><br></center></p>

<p>
<form action="process.php" method="post" accept-charset="UTF-8">



<table style="width: 85%; text-align: left;" border="0" cellpadding="0" cellspacing="2">
<tbody>


<tr><td><b><small>Region</small></b></td><td>
<select name="region">

     <option value="APAC">Asia Pacific Region</>
     <option value="Europe">Europe Region</>
     <option value="LatinAmerica">Latin America Region</>
     <option value="NorthAmerica">North America Region</>
     <option value="Africa">Africa Region</>

</select><i><SMALL>(Where your country belongs to)</SMALL>
</td></tr>

<tr><td><b><small>Real Name<small></b></td><td><input type="text" size="20" name="realname"></td></tr>
<tr><td><b><small>Email<small></b></td><td><input type="text" size="20" name="email"></td></tr>
<tr><td><b><small>Release<small></b></td>
   <td>
     <input type="radio" name="release" value="Fedora 12" checked>Fedora 12</>
    </td>
</tr>
<tr><td><b><small>Media<small></b></td>
    <td>
<select name="media">
     <option value="i386 DVD" selected>i386 DVD</>
     <option value="x86_64 DVD">x86_64 DVD</>
     <option value="ppc DVD">ppc DVD</>
     <option value="i386 Live">i386 Live CD</>
     <option value="x86_64 Live">x86_64 Live CD</>
</select><SMALL><i>(If you are unsure, choose i386)<SMALL></i>
    </td>
</tr>

<tr><td><b><small>Address Line1<small></b></td><td><input type="text" size="20" name="address1"><i><SMALL>(Door no, Street name)</SMALL></i></td></tr>
<tr><td><b><small>Address Line2<small></b></td><td><input type="text" size="20" name="address2"><i><SMALL>(Locality, City)</SMALL></i></td></tr>
<tr><td><b><small>Address Line3<small></b></td><td><input type="text" size="20" name="address3"><i><SMALL>(State, Pincode)</SMALL></i></td></tr>


<tr><td><b><small>Address Line4</small></b></td><td>
<select name="address4">

<option value="Afghanistan">Afghanistan</>
<option value="Aland Islands">Aland Islands</>
<option value="Albania">Albania</>
<option value="Algeria">Algeria</>
<option value="American Samoa">American Samoa</>
<option value="Andorra">Andorra</>
<option value="Angola">Angola</>
<option value="Anguilla">Anguilla</>
<option value="Antarctica">Antarctica</>
<option value="Antigua and Barbuda">Antigua and Barbuda</>
<option value="Argentina">Argentina</>
<option value="Armenia">Armenia</>
<option value="Aruba">Aruba</>
<option value="Australia">Australia</>
<option value="Austria">Austria</>
<option value="Azerbaijan">Azerbaijan</>
<option value="Bahamas">Bahamas</>
<option value="Bahrain">Bahrain</>
<option value="Bangladesh">Bangladesh</>
<option value="Barbados">Barbados</>
<option value="Belarus">Belarus</>
<option value="Belgium">Belgium</>
<option value="Belize">Belize</>
<option value="Benin">Benin</>
<option value="Bermuda">Bermuda</>
<option value="Bhutan">Bhutan</>
<option value="Bolivia">Bolivia</>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</>
<option value="Botswana">Botswana</>
<option value="Bouvet Island">Bouvet Island</>
<option value="Brazil">Brazil</>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</>
<option value="Brunei Darussalam">Brunei Darussalam</>
<option value="Bulgaria">Bulgaria</>
<option value="Burkina Faso">Burkina Faso</>
<option value="Burundi">Burundi</>
<option value="Cambodia">Cambodia</>
<option value="Cameroon">Cameroon</>
<option value="Canada">Canada</>
<option value="Cape Verde">Cape Verde</>
<option value="Cayman Islands">Cayman Islands</>
<option value="Central African Republic">Central African Republic</>
<option value="Chad">Chad</>
<option value="Chile">Chile</>
<option value="China">China</>
<option value="Colombia">Colombia</>
<option value="Comoros">Comoros</>
<option value="Congo">Congo</>
<option value="Congo, The Democratic Republic of the">Congo, The Democratic Republic of the</>
<option value="Cook Islands">Cook Islands</>
<option value="Costa Rica">Costa Rica</>
<option value="Cote D'Ivoire">Cote D'Ivoire</>
<option value="Croatia">Croatia</>
<option value="Cyprus">Cyprus</>
<option value="Czech Republic">Czech Republic</>
<option value="Denmark">Denmark</>
<option value="Djibouti">Djibouti</>
<option value="Dominica">Dominica</>
<option value="Dominican Republic">Dominican Republic</>
<option value="Ecuador">Ecuador</>
<option value="Egypt">Egypt</>
<option value="El Salvador">El Salvador</>
<option value="Equatorial Guinea">Equatorial Guinea</>
<option value="Eritrea">Eritrea</>
<option value="Estonia">Estonia</>
<option value="Ethiopia">Ethiopia</>
<option value="Europe">Europe</>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</>
<option value="Faroe Islands">Faroe Islands</>
<option value="Fiji">Fiji</>
<option value="Finland">Finland</>
<option value="France">France</>
<option value="French Guiana">French Guiana</>
<option value="French Polynesia">French Polynesia</>
<option value="Gabon">Gabon</>
<option value="Gambia">Gambia</>
<option value="Georgia">Georgia</>
<option value="Germany">Germany</>
<option value="Ghana">Ghana</>
<option value="Gibraltar">Gibraltar</>
<option value="Greece">Greece</>
<option value="Greenland">Greenland</>
<option value="Grenada">Grenada</>
<option value="Guadeloupe">Guadeloupe</>
<option value="Guam">Guam</>
<option value="Guatemala">Guatemala</>
<option value="Guernsey">Guernsey</>
<option value="Guinea">Guinea</>
<option value="Guinea-Bissau">Guinea-Bissau</>
<option value="Guyana">Guyana</>
<option value="Haiti">Haiti</>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</>
<option value="Honduras">Honduras</>
<option value="Hong Kong">Hong Kong</>
<option value="Hungary">Hungary</>
<option value="Iceland">Iceland</>
<option value="India">India</>
<option value="Indonesia">Indonesia</>
<option value="Ireland">Ireland</>
<option value="Isle of Man">Isle of Man</>
<option value="Israel">Israel</>
<option value="Italy">Italy</>
<option value="Jamaica">Jamaica</>
<option value="Japan">Japan</>
<option value="Jersey">Jersey</>
<option value="Jordan">Jordan</>
<option value="Kazakstan">Kazakstan</>
<option value="Kenya">Kenya</>
<option value="Kiribati">Kiribati</>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</>
<option value="Korea, Republic of">Korea, Republic of</>
<option value="Kuwait">Kuwait</>
<option value="Kyrgyzstan">Kyrgyzstan</>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</>
<option value="Latvia">Latvia</>
<option value="Lebanon">Lebanon</>
<option value="Lesotho">Lesotho</>
<option value="Liberia">Liberia</>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</>
<option value="Liechtenstein">Liechtenstein</>
<option value="Lithuania">Lithuania</>
<option value="Luxembourg">Luxembourg</>
<option value="Macau">Macau</>
<option value="Macedonia">Macedonia</>
<option value="Madagascar">Madagascar</>
<option value="Malawi">Malawi</>
<option value="Malaysia">Malaysia</>
<option value="Maldives">Maldives</>
<option value="Mali">Mali</>
<option value="Malta">Malta</>
<option value="Marshall Islands">Marshall Islands</>
<option value="Martinique">Martinique</>
<option value="Mauritania">Mauritania</>
<option value="Mauritius">Mauritius</>
<option value="Mayotte">Mayotte</>
<option value="Mexico">Mexico</>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</>
<option value="Moldova, Republic of">Moldova, Republic of</>
<option value="Monaco">Monaco</>
<option value="Mongolia">Mongolia</>
<option value="Montenegro">Montenegro</>
<option value="Montserrat">Montserrat</>
<option value="Morocco">Morocco</>
<option value="Mozambique">Mozambique</>
<option value="Myanmar">Myanmar</>
<option value="Namibia">Namibia</>
<option value="Nauru">Nauru</>
<option value="Nepal">Nepal</>
<option value="Netherlands">Netherlands</>
<option value="Netherlands Antilles">Netherlands Antilles</>
<option value="New Caledonia">New Caledonia</>
<option value="New Zealand">New Zealand</>
<option value="Nicaragua">Nicaragua</>
<option value="Niger">Niger</>
<option value="Nigeria">Nigeria</>
<option value="Niue">Niue</>
<option value="Norfolk Island">Norfolk Island</>
<option value="Northern Mariana Islands">Northern Mariana Islands</>
<option value="Norway">Norway</>
<option value="Oman">Oman</>
<option value="Pakistan">Pakistan</>
<option value="Palau">Palau</>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</>
<option value="Panama">Panama</>
<option value="Papua New Guinea">Papua New Guinea</>
<option value="Paraguay">Paraguay</>
<option value="Peru">Peru</>
<option value="Philippines">Philippines</>
<option value="Poland">Poland</>
<option value="Portugal">Portugal</>
<option value="Puerto Rico">Puerto Rico</>
<option value="Qatar">Qatar</>
<option value="Reunion">Reunion</>
<option value="Romania">Romania</>
<option value="Russian Federation">Russian Federation</>
<option value="Rwanda">Rwanda</>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</>
<option value="Saint Lucia">Saint Lucia</>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</>
<option value="Samoa">Samoa</>
<option value="San Marino">San Marino</>
<option value="Sao Tome and Principe">Sao Tome and Principe</>
<option value="Satellite Provider">Satellite Provider</>
<option value="Saudi Arabia">Saudi Arabia</>
<option value="Senegal">Senegal</>
<option value="Serbia">Serbia</>
<option value="Seychelles">Seychelles</>
<option value="Sierra Leone">Sierra Leone</>
<option value="Singapore">Singapore</>
<option value="Slovakia">Slovakia</>
<option value="Slovenia">Slovenia</>
<option value="Solomon Islands">Solomon Islands</>
<option value="Somalia">Somalia</>
<option value="South Africa">South Africa</>
<option value="Spain">Spain</>
<option value="Sri Lanka">Sri Lanka</>
<option value="Suriname">Suriname</>
<option value="Swaziland">Swaziland</>
<option value="Sweden">Sweden</>
<option value="Switzerland">Switzerland</>
<option value="Taiwan">Taiwan</>
<option value="Tajikistan">Tajikistan</>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</>
<option value="Thailand">Thailand</>
<option value="Togo">Togo</>
<option value="Tokelau">Tokelau</>
<option value="Tonga">Tonga</>
<option value="Trinidad and Tobago">Trinidad and Tobago</>
<option value="Tunisia">Tunisia</>
<option value="Turkey">Turkey</>
<option value="Turkmenistan">Turkmenistan</>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</>
<option value="Tuvalu">Tuvalu</>
<option value="Uganda">Uganda</>
<option value="Ukraine">Ukraine</>
<option value="United Arab Emirates">United Arab Emirates</>
<option value="United Kingdom">United Kingdom</>
<option value="United States">United States</>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</>
<option value="Uruguay">Uruguay</>
<option value="Uzbekistan">Uzbekistan</>
<option value="Vanuatu">Vanuatu</>
<option value="Venezuela">Venezuela</>
<option value="Vietnam">Vietnam</>
<option value="Virgin Islands, British">Virgin Islands, British</>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</>
<option value="Wallis and Futuna">Wallis and Futuna</>
<option value="Yemen">Yemen</>
<option value="Zambia">Zambia</>
<option value="Zimbabwe">Zimbabwe</>


</tbody>
</table>
<img src="https://fedoraproject.org/w/uploads/thumb/6/61/Stop_%28medium_size%29.png/35px-Stop_%28medium_size%29.png"><font color="red">Now you will be taken to another page. DON'T CHANGE anything there. <br>Just scroll down and press "Submit Ticket" at the bottom of the page.</font><br><br>
<input type="submit" value="Take me to the next page"><input type="reset" value="Clear">
</form>

<p class="disclaimer">
<img src="https://fedoraproject.org/w/uploads/thumb/f/fd/Warning_%28medium_size%29.png/35px-Warning_%28medium_size%29.png"><img src="https://fedoraproject.org/w/uploads/thumb/f/fd/Warning_%28medium_size%29.png/35px-Warning_%28medium_size%29.png"><img src="https://fedoraproject.org/w/uploads/thumb/f/fd/Warning_%28medium_size%29.png/35px-Warning_%28medium_size%29.png"><br>



<small>
1. One CD/DVD per person per release.<br>
2. Any <b>duplicate</b> requests will result in <b>rejection</b> of all your requests.<br>
3. Please note, Your request <b>may</b> or <b>may not</b> be accepted by the program based on our Capacity.<br>
4. Make sure to use <a href='http://www.upu.int/post_code/en/postal_addressing_systems_member_countries.shtml'>Universal Postal Union Standard Address</a> including <b>Postcode</b> and <b>Country</b>. <br> &nbsp &nbsp Otherwise we can not accept your request!<br>
5. To comply with GPL, <a href="FreeMedia-source.html">Source Code</a> on media is available upon request.

</small>
</p>


       </div>
<pre>
</pre>
     </div>
   </div>
   <div id="bottom">
     <div id="footer">
       <p class="disclaimer">

       The Fedora Project is maintained and driven by the community and sponsored by Red Hat.  This is a community maintained site.  Red Hat is not responsible for content.
       </p>
       <ul>
         <li class="first"><a href="http://fedoraproject.org/wiki/Legal">Legal</a></li>
         <li><a href="http://fedoraproject.org/wiki/Legal/TrademarkGuidelines">Trademark Guidelines</a></li>

       </ul>
     </div>
   </div>

 </body>


</html>
